<div class="container"> 
	<div class="row"> 
		<div class="panel panel-info">
			<div class="panel-heading">
				<div class="panel-title">Push Domains</div>
			</div>
			<div class="panel-body">
				<div class="row">
					<div class="col-md-12">
						<div class="well">
							<!--<h3>Blank Page</h3>
							<hr style="background:skyblue;height:1px;">-->
							<div class="row">
								<div class="col-md-6" >
									<form role="form">
                                      <div class="form-group">
                                        <label for="exampleInputEmail1">Domains to Push</label>
                                        <textarea class="form-control" id="exampleInputEmail1"  style="height:100px;"></textarea>
                                      </div>
                                      <div class="form-group">
                                        <label for="exampleInputEmail1">Push Domains To</label>
                                        <input type="text" class="form-control" id="exampleInputEmail1"  />
                                        <p>Login ID of the account you wish to push to.</p>
                                      </div>
                                      <div class="form-group">
                                      	<label for="exampleInputEmail1">Contact Information</label>&nbsp;&nbsp;&nbsp;
                                      	<label class="radio-inline">
                                          <input type="radio" name="inlineRadioOptions" id="inlineRadio1" value="option1"> Push with domain 
                                        </label>
                                        <label class="radio-inline">
                                          <input type="radio" name="inlineRadioOptions" id="inlineRadio2" value="option2"> Do not push
                                        </label>
                                      </div>
                                      
                                      <button type="submit" class="btn btn-warning">Push Domains</button>
                                    </form>
								</div>
							</div>
							
						
						</div>
					</div>
				</div>	
			</div>
		</div>
	</div>
</div>
